Prospective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine

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dc.contributor.authorTuon F.F.
dc.contributor.authorGavrilko O.
dc.contributor.authorAlmeida S.D.
dc.contributor.authorSumi E.R.
dc.contributor.authorAlberto T.
dc.contributor.authorRocha J.L.
dc.contributor.authorRosa E.A.
dc.date.accessioned2024-03-13T00:49:51Z
dc.date.available2024-03-13T00:49:51Z
dc.date.issued2017
dc.description.abstract© 2017 International Society for Chemotherapy of Infection and CancerObjectives Chlorhexidine (CHX) is the most commonly used oral hygiene product for the prevention of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation (MV). The change in dental plaque (DP) microbiota following CHX use in patients under MV has not been described previously. The aim of this study was to evaluate the incidence of pathogenic bacteria associated with VAP and the coverage of DP within the oral cavity in patients administered CHX. Methods This was a prospective, randomised, controlled, double-blind study in patients (n = 16) under MV who were mouth-rinsed with either CHX or placebo. Microbiology samples were collected from the oral mucosa (OM) and DP after admission to the ICU and on Days 3, 5, 7 and 10. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of CHX were determined. Results Upon admission, the occurrence of multidrug-resistant (MDR) bacteria, including carbapenem-resistant Klebsiella pneumoniae, was reported. The CHX group had a lower incidence of methicillin-resistant Staphylococcus aureus (MRSA) compared with the placebo group for the OM (RR = 0.51, 95% CI 0.27–0.98; P = 0.011). There was high agreement between the culture results of OM and DP (κ = 0.825). VAP developed in six patients. The species identified following tracheal aspiration of VAP patients were similar to those found in the OM for four cases. The strains showed low MICs and MBCs for CHX (<0.039 mg/mL). Conclusions Although DP is rapidly colonised by MDR bacteria, use of 2% CHX reduced the incidence of S. aureus colonisation.
dc.description.firstpage159
dc.description.lastpage163
dc.description.volume8
dc.identifier.doi10.1016/j.jgar.2016.12.007
dc.identifier.issn2213-7173
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/35785
dc.relation.ispartofJournal of Global Antimicrobial Resistance
dc.rightsAcesso Restrito
dc.subject.otherlanguageChlorhexidine
dc.subject.otherlanguageInfection
dc.subject.otherlanguageIntensive care unit
dc.subject.otherlanguageMechanical ventilation
dc.subject.otherlanguageMicrobiota
dc.subject.otherlanguageOral hygiene
dc.titleProspective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine
dc.typeArtigo
local.scopus.citations31
local.scopus.eid2-s2.0-85013149681
local.scopus.subjectAdult
local.scopus.subjectAged
local.scopus.subjectAged, 80 and over
local.scopus.subjectAnti-Infective Agents, Local
local.scopus.subjectBacteria
local.scopus.subjectChlorhexidine
local.scopus.subjectDental Plaque
local.scopus.subjectDouble-Blind Method
local.scopus.subjectFemale
local.scopus.subjectHumans
local.scopus.subjectIntensive Care Units
local.scopus.subjectMale
local.scopus.subjectMicrobial Sensitivity Tests
local.scopus.subjectMicrobial Viability
local.scopus.subjectMicrobiota
local.scopus.subjectMiddle Aged
local.scopus.subjectMouth Mucosa
local.scopus.subjectOral Hygiene
local.scopus.subjectPlacebos
local.scopus.subjectProspective Studies
local.scopus.subjectTreatment Outcome
local.scopus.subjectYoung Adult
local.scopus.updated2024-05-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85013149681&origin=inward
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